Even though she always took good care of herself, Pearl Walker still had problems with her heart. “Everyone was shocked to find out that I had heart disease,” said Walker. “I eat well and exercise and I’m not overweight. I’m in good health.” But despite all of her good habits she had one thing working against her -- genetics. Her mother had heart disease.
Twelve years ago doctors discovered that Walker had a blockage in an artery next to the main coronary artery. Doctors gave her blood pressure medication to slow the blood flow to her heart.
Two years later Walker’s cardiologist said that it was too dangerous to do anything about the blockage next to the main artery. After that, Walker said she felt all right until eight months ago.
In November 2004, Walker went to her cardiologist. “I was having problems. I had pains in my arms and when I would exercise it hurt my chest. It went away but then continued from time to time but the doctor didn't seem concerned,” she said.
She described the sensation in her chest as a mild aching that occurred when she walked or exerted herself a little. “It hit me in the chest and arm. The pains would hit me and then go away. I had no energy,” said Walker.
Then on New Year’s Eve Walker went to the emergency room at a hospital in her hometown of Waynesboro, Pennsylvania, because she was in the process of having a heart attack. “But they gave me blood thinner and morphine, so I didn’t have the heart attack,” said Walker. She was then transferred to another hospital where a catheterization was done.
It turns out that Walker had coronary artery disease with blockage of two arteries in her heart -- the left anterior descending and the circumflex. Fortunately for Walker, the hospital contacted the University of Maryland Medical Center’s Maryland Heart Center. “They said they had this new (hybrid) procedure and I was a prime candidate for it,” Walker recalled.
That procedure is known as minimally invasive coronary artery bypass (MIDCAB) with stented angioplasty (the “Hybrid” procedure). The hybrid procedure is an innovative approach to double or triple vessel coronary artery disease. It combines minimally invasive coronary artery bypass surgery with stented angioplasty at the same time. Stents are small wire tubes that keep narrowed arteries open.
With the minimally invasive direct coronary bypass, the surgeon creates a tiny, two-and-a-half inch opening between two ribs in the left side of the chest. The doctor then removes part of another artery from the chest through this keyhole-size opening and sews it to the heart to bypass the blocked artery.
With this minimally invasive surgery, the heart remains beating throughout the procedure, which is safer and poses fewer side effects than having the patient on a heart-lung machine to maintain circulation.
During this procedure, the cardiac surgeon works with a cardiologist who specializes iin cardiac catheterization. When the bypass surgery is complete, the cardiologist performs the angioplasty to restore normal blood flow in arteries that are not blocked enough to require a bypass. To reduce the chance that the blockage will recur, the doctor uses stents coated with a medication that prevent reblocking, also known as restenosis.
According to UM Medical Center physicians, there are several advantages to this approach -- it benefits patients because it is more convenient and less stressful to have both bypass surgery and stenting performed at the same time, rather than on separate days. Another advantage for patients is that this type of bypass surgery can be performed without a major incision. Patients can also expect quicker recovery times and reduced hospital stays.
“I Feel Like a New Person”
After the operation, Walker’s earlier symptoms disappeared. ”I feel good now; I feel like a new person,” she said.
Walker had her operation on a Wednesday and went home that Friday night. The next morning after surgery, she was already walking short distances. She says the minimally invasive approach was “wonderful.” And she is grateful that this procedure was available to her. “I was really pleased that something like this could be done. It’s great that they are making all of these advances. It gives you extra time to live. I was so excited about this surgery.”
By Michelle W. Murray